Outline

Background: Cardiovascular events occur most frequently in the early morning. It has been reported, that an exaggerated morning blood pressure surge (MBPS) was associated with silent hypertensive cerebrovascular disease. Therefore the aim of this study was to analyze, if there is a link between MBPS and ambulatory detected ST-segment depression.

Results: The prevalence of ST segment depression did not differ between the Surge group (MBPS Â³45 mm Hg, n = 37) and the Nonsurge group (MBPS < 45 mm Hg, n = 315) and amounted 22% and 22% respectively. 626 episodes of transient ST segment depression could be demonstrated in 47 patients. In 29 patients a depressed baseline ST segment of more than -0.10 mV was observed. The transient ST segment depression between 6 and 9 a.m. were characterized by a higher mean duration, a higher cumulative duration per hour and by a significant higher systolic blood pressure value (Table 1 [Tab.Â 1]).

Conclusion: ST-segment depression, detected with Cardiotens, has a circadian peak in the early morning hours like other cardiovascular events. Its duration is more severe, and systolic BP, as a possible trigger mechanism of such episodes, is higher in the early morning hours, than compared to other daytimes. An association between MBPS Â³45 mm Hg with ST segment depression could not be demonstrated.